Soft Tissue-Lower Extremity

Question 1

Iliotibial Band Tension(ITB) Prone, Counterleverage

Answer 1

1. The patient lies prone and the physician stands on the left side of the patient.
2. The patient’s right knee is flexed to 90 degrees
3. The physician’s right hand grasps the patient’s right foot
   or lower leg while reaching over the patient to place the left hand, palm down, over the patient’s right lateral thigh
4. The physician begins to push the patient’s foot and lower leg laterally while simultaneously compressing the right hand into the patient’s lateral thigh to engage the ITB pulling posteromedially to its restrictive barrier
5. On meeting the ITB’s restrictive barrier, the physician can maintain the tension for 10 to 20 seconds and slowly release the tension and repeat until a maximum release of the tissue is noted or perform this technique in a slow, rhythmic manner, which is repeated over a few minutes or until the tissue texture is maximally improved.
6. To disengage the tension on the ITB, the physician pulls the patient’s foot/lower leg back toward the midline while decreasing the pressure on the lateral thigh
7. Tissue tension is reevaluated to assess the effectiveness of the technique

Question 2

Iliotibial Band Tension(ITB) Lateral Recumbent, Effleurage/Petrissage

Answer 2

1. The patient lies in the right lateral recumbent position and the physician stands facing the front of the patient.
2. The physician’s left hand rests on the posterolateral aspect of the patient’s left iliac crest to stabilize the pelvis.
3. The physician makes a “fist” with the right hand and places the flat portion of the proximal phalanges over the distal, lateral thigh.
4. The physician adds slight pressure into the distal ITB and begins to slide the hand toward the trochanteric.
5. This is repeated for 1 to 2 minutes and then the tissue tension is reevaluated to assess the effectiveness of the technique.
6. If preferred, the physician can alternate from the distal to proximal stroking and perform a proximal to distal stroking, ending at the distal ITB.